MEDICARE: JULIA N HART MA ED. PPS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist	20089674	CA

General Provider Information

NPI Number	:	1679314306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA N HART MA ED. PPS

Provider Business Mailing Address
First Line	:	1200 SOLANO AVE
Second Line	:
City	:	ALBANY
State	:	CA
Zip	:	94706-1725
Country	:	US
Telephone Number	:	510-558-3750
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 SOLANO AVE
Second Line	:
City	:	ALBANY
State	:	CA
Zip	:	94706-1725
Country	:	US
Telephone Number	:	510-558-3750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2024
Last Update Date	:	06/05/2024

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